Basics Of Heart Bypass Surgery

Your heart is supplied with blood by two coronary arteries. Over time, these arteries can develop blockages as the result of plaque buildup along the arterial walls. When plaque builds up along the wall, it narrows the passageway through which blood travels. If your heart is deprived of oxygen-rich blood, it can trigger angina (severe chest pain) or a myocardial infarction. One solution to this problem is a coronary artery bypass graft (CABG).

This procedure seeks to restore the flow of blood by grafting another vein into the blocked artery in order to circumvent the blockage. The grafted vein typically comes from the patient’s body – either the leg, arm, or chest.

In this article, we’ll provide a brief overview regarding what is involved during the procedure. We’ll also describe less invasive techniques that are being used by a growing number of surgeons.

During The Procedure

The surgeon will first identify the location and severity of the arterial obstructions. This is done in order to determine the most appropriate grafts to use. In most cases, an internal mammary artery (located inside the chest wall) is used. This is due to its proximity to the coronary arteries and the fact that it has an oxygen-rich blood supply (it is attached to the aorta). A saphenous vein from the leg can also be used and can be removed without the surgeon making a long incision.

A less-common strategy is to use a radial vein from the arm. Your arm has two arteries, the radial and the ulnar. It can receive a sufficient supply of blood from the ulnar alone.

The surgeon will begin the CABG by making an incision just below the obstruction within the affected coronary artery. If the operation involves the internal mammary artery, one end is grafted below the blockage. The other end is left attached to the aorta. If the CABG involves using a saphenous or radial vein, one end is grafted into the aorta while the other end is grafted below the blockage.

The entire CABG normally requires four to five hours; grafting multiple blockages will take more time than grafting a single blockage.

Less Invasive Technique

A minimally invasive technique can be used if the patient requires a bypass of the left coronary artery and an internal mammary artery can be used for the graft. Instead of making a long incision into the chest and cutting through the breastbone, a small incision is made between the ribs. Robotic arms can be inserted and controlled by the surgeon in order to perform the graft. By avoiding open chest surgery, the surgical team can reduce the likelihood of infection. Also, this minimally invasive strategy decreases the patient’s recovery time.

Heart bypass surgery is common. Nearly 300,000 people in the U.S. undergo the procedure each year. If your coronary arteries develop blockages, speak with your physician to determine whether a minimally invasive CABG is an appropriate solution.

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